How Do You Qualify for Medicare?
Medicare is a federally-funded health insurance program. American citizens living in the United States qualify for Medicare once they turn 65. They may also qualify if they are under 65 and meet one of the following conditions:
- Receive Social Security disability insurance (SSDI) for at least 24 months
- Have End-Stage Renal Disease (ESRD)
- Have amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig's disease)
- Receive Railroad Retirement Benefits
There is no income requirement to qualify for Medicare.
What Medicare Plans Are Available in Texas?
Medicare enrollees have multiple options to receive their benefits.
- Original Medicare includes Part A (hospital insurance) and Part B (medical insurance)
- Medicare Advantage(MA) plans, also known as Part C, cover the same services as Original Medicare, with most MA plans offering additional coverage
- Medicare Part D plans provide prescription drug coverage
- Medicare Supplement Insurance plans, also known as Medigap, help pay for some of the costs not covered by Original Medicare
Private insurance companies provide Medicare Advantage, Part D, and Medigap plans. Coverage and costs vary according to each plan and provider. However, beneficiaries still pay their Part B premium, even if they have an MA plan.
Texas does not require Medigap providers to offer plans to beneficiaries who are under age 65.
Medicare Savings Programs in Texas
Although Medicare is a federally-funded program, there are state-level programs to help Texans pay their Medicare costs. These are known as Medicare Savings Programs (MSPs) and include:
- Qualified Medicare Beneficiary (QMB) Program
- Special Low-Income Medicare Beneficiary (SLMB) Program
- Qualifying Individual (QI) Program
- Qualified Disabled and Working Individuals (QDWI) Program
While Medicare has no income requirements, MSPs do. Refer to the table below to see the income and resource limits for each program. If you are still employed, you may qualify even if your income exceeds these limits. It's always worth applying to see if you qualify.
Medicare Savings Program Requirements (Texas)
$1,153 Per Month
$1,379 Per Month
$1,549 Per Month
$4,615 Per Month
$1,546 Per Month
$1,851 Per Month
$2,080 Per Month
$6,189 Per Month
All out-of-pocket costs
Part B Premiums
Part B Premiums
Part A Premiums
Additional Texas Medicare Resources
You can also call ClearMatch™ Medicare toll-free at 1-888-992-0738. Our licensed agents are happy to answer your questions and guide you through the Medicare program. The best part? Working with ClearMatch™ Medicare is always free!